The Risk Ratio of Immune-Related Colitis, Hepatitis, and Pancreatitis in Patients With Solid Tumors Caused by PD-1/PD-L1 Inhibitors: A Systematic Review and Meta-Analysis

Frontiers in Oncology

Shuisheng Zhang¹  Xiaowei Yang²  Zewen Zhang³  Chenxing Jin⁴  Yi Zhao⁴  Yantao Mao⁵  Li Zhang⁶  Yuan Tian⁷  Donghua Li⁸  Zhuoqi Li⁹ 

[1] Department of General Surgery, Peking University Third Hospital, Beijing, China;Department of Hepatobiliary Intervention, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China;Department of Imaging Medicine and Nuclear Medicine, Qilu Medical College, Shandong University, Jinan, China;Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, China;Department of Oncology, Yantaishan Hospital of Shandong Province, Yantai, China;Department of Pathology, Zaozhuang Municipal Hospital, Zaozhuang, China;Department of Radiotherapy Oncology, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated With Shandong First Medical University, Jinan, China;Department of Radiotherapy, The People's Hospital of Yuncheng County, Heze, China;Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Division of Etiology, Peking University Cancer Hospital and Institute, Beijing, China;

关键词: PD-1/PD-L1;    chemotherapy;    immune-related inflammation;    solid tumor;    meta-analysis;   

DOI  :  10.3389/fonc.2020.00261

来源: DOAJ

【 摘 要 】

Purpose: The meta-analysis was put into practice in evaluating the risk ratio of immune-related digestive system inflammation in patients with solid tumors caused by PD-1/PD-L1 inhibitors.Method: The process of the meta-analysis was performed by us according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.Results: After screening and eligibility assessment, a total of 26 clinical trials involving 16,409 patients were selected for the final quantitative synthesis. Immune-related digestive system inflammations, including colitis, hepatitis, pancreatitis, were evaluated separately. Compared with chemotherapy, PD-1/PD-L1 inhibitors led to an increase in the incidence risk of all grade colitis (RR = 2.43, 95% CI: [1.23, 4.82], P = 0.01). Similar incidence trend could also be seen when PD-1/PD-L1 inhibitors were combined with chemotherapy (RR = 2.62, 95% CI: [1.25, 5.48], P = 0.01). Whether compared with Nivolumab plus Ipilimumab or Ipilimumab alone, the incidence risk of colitis in the Nivolumab group was significantly lower than that of the control group. Similar analysis results could also be seen in the incidence risk of hepatitis. We did not find a statistically significant effect on the incidence of immune-related pancreatitis after the use of PD-1/PD-L1 inhibitors.Conclusion: The use of PD-1/PD-L1 inhibitors increased the incidence risk of immune-related colitis and hepatitis, but this potential to increase the incidence risk of the disease was weaker than Ipilimumab.

【 授权许可】

Unknown